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ForumsRetatrutide & Triple AgonistsRetatrutide and fatty liver — November 2025 Page 2

Retatrutide and fatty liver — November 2025

kevin_tulsa Wed, Nov 27, 2024 at 5:25 PM 9 replies 1,540 viewsPage 2 of 2
AussieAnna
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Sydney, AU
Nov 27, 2024 at 8:15 PM#6

Sorry if this is a dumb question but how is this different from tirzepatide? I thought Mounjaro was already the "best" option. Now there's something even better? How long until insurance would cover this?

30 23TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 27 others
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EndoResFellow
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Sep 2024
Baltimore, MD
Nov 27, 2024 at 8:32 PM#7

Not a dumb question at all. The key difference is the third receptor:

  • Semaglutide = GLP-1 agonist (one receptor)
  • Tirzepatide = GLP-1 + GIP agonist (two receptors)
  • Retatrutide = GLP-1 + GIP + glucagon agonist (three receptors)

The glucagon component is theorized to increase energy expenditure (thermogenesis) and promote hepatic fat oxidation. So you're not just reducing appetite — you're also potentially burning more calories at rest. That's the mechanistic hypothesis for the superior efficacy.

As for insurance: Lilly hasn't filed yet. Optimistic timeline is FDA approval late 2026, commercial launch early 2027. Insurance coverage usually lags 6-12 months after that, depending on the payor.

Last edited: Nov 27, 2024 at 10:32 PM
20 22TinaHashiRN, robert_kc, dan_philly and 17 others
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Dr.KarenChen
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Nov 27, 2024 at 8:49 PM#8

One thing that isn't getting enough attention: the TRIUMPH-4 trial is studying retatrutide specifically for MASH (metabolic-associated steatohepatitis). The Phase 2 liver fat data was remarkable — something like 80%+ of participants achieved ≥70% liver fat reduction. If that holds up in Phase 3, retatrutide could be approved for both obesity AND liver disease, which would be a first for any incretin.

This is the drug I'm most excited about in the pipeline, full stop.

Last edited: Nov 28, 2024 at 2:49 AM
9 20TomFromTexas, mike.trainer_LA, sarah_nash92 and 6 others
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